Craniosynostosis and nutrient intake during pregnancy
Suzan L Carmichael1, Sonja A Rasmussen, Edward J Lammer
1California Research Division, March of Dimes Foundation, Oakland, California, USA. scarmichael@stanford.edu
Insights
Maternal intake of folic acid supplements did not link to craniosynostosis. However, specific dietary nutrients like riboflavin and vitamins B6, E, and C may influence sagittal synostosis risk.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Surgery
- Nutritional Science
Background:
- Craniosynostosis is a birth defect involving premature fusion of skull sutures.
- Maternal factors, including nutrient intake, are investigated for their role in craniosynostosis etiology.
- Folic acid supplementation is a known preventive measure for neural tube defects, prompting research into its role in other congenital anomalies.
Purpose of the Study:
- To investigate the association between maternal intake of folic acid supplements and dietary nutrients with the risk of craniosynostosis.
- To explore potential differences in nutrient associations based on the specific type of craniosynostosis (sagittal, metopic, coronal).
Main Methods:
- A case-control study utilizing data from the National Birth Defects Prevention Study (1997-2005).
- Nonsyndromic craniosynostosis cases (n=815) were compared to population-based controls (n=6789).
- Logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs), controlling for various maternal and demographic factors.
Main Results:
- Maternal folic acid supplement intake showed no association with craniosynostosis.
- Higher dietary intake of riboflavin, vitamins B6, E, and C was associated with a significantly lower risk of sagittal synostosis.
- Increased intake of choline and vitamin B12 was linked to a higher risk of metopic synostosis, while methionine and vitamin C intake correlated with lower coronal synostosis risk.
Conclusions:
- Dietary intake of specific nutrients, beyond folic acid, may play a role in the development of craniosynostosis.
- The association between nutrient intake and craniosynostosis appears to be dependent on the specific skull suture involved.
Objective:
To examine the association of craniosynostosis with maternal intake of folic acid-containing supplements and dietary nutrients.
Methods:
The study included deliveries from 1997 to 2005 from the National Birth Defects Prevention Study. Nonsyndromic infants with craniosynostosis (n = 815) were compared to nonmalformed, population-based liveborn control infants (n = 6789), by estimating adjusted odds ratios (AORs) and 95% confidence intervals (CIs) from logistic regression models that included mother's age, parity, race-ethnicity, education, body mass index, smoking, alcohol, fertility treatments, plurality, and study center. We compared quartiles of intake and specified nutrients as continuous.
Results:
Intake of folic acid-containing supplements was not associated with craniosynostosis (AORs were close to 1). Analyses of dietary nutrients were restricted to mothers who took supplements during the first trimester (i.e., most women). Based on continuous specifications of nutrients, sagittal synostosis risk was significantly lower among women with higher intake of riboflavin and vitamins B₆, E, and C; metopic synostosis risk was significantly higher among women with higher intakes of choline and vitamin B₁₂; and coronal synostosis risk was significantly lower among women with higher intake of methionine and vitamin C. As examples, AORs for sagittal synostosis among women with intakes of vitamin B₆ and riboflavin in the highest versus lowest quartiles were 0.4 (95% CI, 0.2-0.6) and 0.5 (95% CI, 0.3-0.7), respectively.
Conclusion:
This analysis suggests that dietary intake of certain nutrients may be associated with craniosynostosis, and results may vary by suture type.
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